Surgical Indications and Results of Mitral Valve Repair in Pediatric Patients With Ventricular Septal Defects Accompanied by Mitral Valve Regurgitation

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Surgical Indications and Results of Mitral Valve Repair in Pediatric Patients With Ventricular Septal Defects Accompanied by Mitral Valve Regurgitation Woo Sung Jang, MD, PhD, Woong-Han Kim, MD, PhD, Joon Yong Cho, MD, Kwangho Choi, MD, Eun Seok Choi, MD, Young Ok Lee, MD, PhD, Gun-Jik Kim, MD, Jeong Ryul Lee, MD, PhD, Yong Jin Kim, MD, PhD The Annals of Thoracic Surgery Volume 99, Issue 3, Pages 891-897 (March 2015) DOI: 10.1016/j.athoracsur.2014.11.004 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Representative mitral valve repair techniques. (A) Asymmetric annuloplasty to the posteromedial commissure. (B) Posterior annulus plication. The Annals of Thoracic Surgery 2015 99, 891-897DOI: (10.1016/j.athoracsur.2014.11.004) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Preoperative mitral regurgitation (MR) grade in both groups. The Annals of Thoracic Surgery 2015 99, 891-897DOI: (10.1016/j.athoracsur.2014.11.004) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Mitral valve (MV) repair technique. Posteromedial commissure annuloplasty and posterior annuloplasty were the standard repair techniques. The Annals of Thoracic Surgery 2015 99, 891-897DOI: (10.1016/j.athoracsur.2014.11.004) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Mitral regurgitation (MR) grade changes over time. All patients showed an MR grade of 2 or lower after mitral valve repair at latest follow-up. In patients who did not undergo mitral valve repair, all patients showed the same or lower degree of MR at discharge, and maintained the same or lower degree of MR at the latest follow-up. (A) MR grade in group I. (B) MR grade in group II. (Preop = preoperative.) The Annals of Thoracic Surgery 2015 99, 891-897DOI: (10.1016/j.athoracsur.2014.11.004) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Mitral regurgitation (MR) grade changes in patients with MR grades 1 and 2. All patients in group I with an MR grade of 2 showed MR grade improvement after mitral valve repair at the most recent follow-up. However, 6 patients (25.0%) in group II remained at MR grade 2 at the latest follow-up. (A) MR grade in group I. (B) MR grade in group II. (Preop = preoperative.) The Annals of Thoracic Surgery 2015 99, 891-897DOI: (10.1016/j.athoracsur.2014.11.004) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions